National Provider Identifier [NPI]: |
1346336856 |
Last Name Of The Provider |
MORRIS |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4110 S 110TH E AVE. |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
TULSA |
Zip Code Of The Provider |
74146 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
82 |
Number Of Services |
5173 |
Number Of Medicare Beneficiaries |
645 |
Total Submitted Charge Amount |
746949.64 |
Total Medicare Allowed Amount |
244101.97 |
Total Medicare Payment Amount |
185186.02 |
Total Medicare Standardized Payment Amount |
192127.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
2576 |
Number Of Medicare Beneficiaries With Drug Services |
57 |
Total Drug Submitted ChargeAmount |
33091.95 |
Total Drug Medicare AllowedAmount |
14994.82 |
Total Drug Medicare PaymentAmount |
11755.87 |
Total Drug Medicare Standardized Payment Amount |
11755.87 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
71 |
Number Of Medical Services |
2597 |
Number Of Medicare Beneficiaries With Medical Services |
645 |
Total Medical Submitted Charge Amount |
713857.69 |
Total Medical Medicare Allowed Amount |
229107.15 |
Total Medical Medicare Payment Amount |
173430.15 |
Total Medical Medicare Standardized Payment Amount |
180371.36 |
Average Age Of Beneficiaries |
59 |
Number Of Beneficiaries Age Less65 |
421 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
415 |
Number Of Male Beneficiaries |
230 |
Number Of Non Hispanic White Beneficiaries |
505 |
Number Of Black or African American Beneficiaries |
50 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
76 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
326 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
319 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
4 |
Percent Of With Heart Failure |
28 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
50 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
61 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.4746 |